Unfortunately, the physical and physiological changes during pregnancy can lead to various aches and pains in your pelvic area. If you feel it severe pain in your pubic area (front of your pelvis), this may indicate common pregnancy pains called Symphysis Pubis Dysfunction (SPD).
In this post, we’ll help you understand SPD symptoms and common causes. Then, we’ll share some helpful exercises to reduce pain (or prevent it in the first place), and what to avoid to prevent it from getting worse.
Symptoms of SPD
The most common symptoms of SPD are bad pain in the pubic area (front of pelvis). However, in some cases the pain radiates from this area down to the upper thighs and perineum (the area between the anus and the genitals). Same as SI Joint Pain — another type of pelvic girdle pain felt in rear end (or back) of the pelvis — SPD pain often worsens with weight-bearing activity, especially single leg activity (such as walking, running, climbing stairs, or even getting in and out of a car). You may also feel pain when you grow your legs.
Common Causes of SPD
Pain is felt when stress is increased joint of the pubic symphysis (circled in red below), which connects your left and right pelvic bones to the bottom of your pelvis.
During pregnancy, the following factors can create increased stress:
- Pregnancy Alignment Changes: Pregnancy tends to pull the body out of neutral alignment – often lifting the pelvis forward in a anterior pelvic tilt, as you can see in the picture below. This too the body changes center of gravity up and out. Together, the tipped pelvis plus shifted center of gravity places more weight on the pubic symphysis.
- Hormonal Changes: During pregnancy, hormonal changes — specifically an increase in the so-called hormone relaxin – relax the tension of soft tissues in the body. This soft tissue laxity helps increase mobility of the pelvis in preparation for childbirth. The consequence of this added pelvic motion is a decrease in the stability of the bony structures, which can make the pubic symphysis joint hypermobile. This means there is more movement than usual, which can lead to disease.
- Increased body weight: Increased weight as pregnancy progresses increases the forces through the pelvis, exacerbating the two issues above.
Remember: Because some hormonal changes from pregnancy continue into the postpartum period, increased mobility and decreased stability can is still present after giving birth (there is debate as to how long this period lasts), so SPD can also occur in the postpartum period.
6 Focus Exercises
Now that you understand the contributing factors that can lead to SPD, it’s time to focus on things you can do to help support your body to reduce the symptoms of SPD, or avoid it altogether:
1. Find Neutral Alignment: OK, so this first one isn’t technically an “exercise,” but it is one most important tip to help reduce SPD. It has to do with entering your body neutral alignment to reduce pressure on the pubic symphysis joint. Watch the video below to learn how to keep your body neutral, and try to remember this as you go about your day — especially during long periods of standing or walking.
2. 360° Breathing: Once you are in neutral alignment, this is the first and most important step to master. This activates your deep core muscles, which are critical for providing stability to the pubic symphysis joint. Watch this video to learn how to master the technique, then (important) incorporate it into your movements.
3. Pelvic Floor Activities (PFAs): One of the primary responsibilities of the pelvic floor muscles is to help stabilize the pelvis. The stronger these muscles are, the better they can support your pelvis, reducing stress on the pubic symphysis joint. Watch this video to learn a step-by-step process to find your pelvic floor muscles first (HINT: these aren’t your only “pee-holding” muscles), then learn how to work these muscles through a full range of motion linked to your 360° Breathing.
4. Bridges: Your glutes work your core to stabilize your pelvis, so strengthening your glutes is important for alleviating SPD pain. Bridges are a great way to target your glutes because they keep your pelvis in a stable position. It is also a safe exercise to do in total pregnancy because, even if you are behind, you are moving the whole time. Of course, if you are not comfortable with your back, you can do it bridge with shoulders up diversity.
5. Ground Pickup (or Deadlift): The Ground Pickup is essentially a Deadlift, but we refer to it this way because we want you to relate this action to how you pick things up in your everyday life. Like bridges, this movement also targets the glutes while keeping the pelvis in a stable position.
6. Incline Plank: The plank is a great exercise that helps to stabilize the front of the pelvis and strengthen the glutes. Since the whole plank must change as pregnancy progresses, you can do this simple regression in an incline to get the main strengthening benefit without overtaxing the abdominal muscles.
3 Types of Exercise to Avoid
If you are experiencing symptoms of SPD, then avoid the types of movements below. Remember, it is not necessary to avoid these movements if yes no experiencing SPD pain.
- Single-leg movements: During lunges, step-ups, or other single-leg patterns, the pelvis is loaded more on one side than the other, which can make the pain worse. Therefore, stay on bilateral moves, such as squats and deadlifts, with an equal load on both sides.
- Effect: Impact motions such as running, jumping, or other ballistic motions are likely to worsen pain due to hypermobility in your pelvis. Your body will let you know if these moves are inappropriate.
- Spread both legs at the same time: Doing any movement where both legs are spread (ie, wide plies, straddle positions, or any stretch with the legs apart) can put extra strain on the pubic symphysis joint, which is already under extreme stress. If you want to stretch the inner thigh/groin area, do it gently on one side at a time.
Want More Help?
For effective prenatal workouts that will help you gain strength and relieve common pregnancy pains like SPD, explore our prenatal training programs. These programs include a “pelvic pain modification guide” to help you modify the necessary exercises if you feel pain. Or, consider working with one of our experts Pronatal Personal Trainers, who are skilled in dealing with diseases and injuries such as SPD.
Interested in Coaching Pre & Postnatal Clients?
Are you a fitness or health professional interested in working with pre and postnatal clients? Explore our Pre/Postnatal Professional Education.
